LAPAROSCOPIC AND OPEN MINOR LIVER RESECTIONS FOR COLORECTAL LIVER METASTASES
DOI:
https://doi.org/10.15407/oncology.2025.04.252Keywords:
colorectal cancer, liver metastases, laparoscopic liver resection, laparoscopic surgery costs, state hospitalAbstract
Summary. In 2017 the laparoscopic left lateral sectionectomy and minor resections of the anterior liver segments were considered the standard of practice worlwide. However, in 2023 only 5% of liver resections were conducted laparoscopically within the Ukrainian specialized centres. Aim: to investigate if the laparoscopic minor liver resections (LLR) have better financial, surgical and long-term oncological outcomes compared to open liver resections (OLR) in the two state specialized hospitals in Ukraine since the full-scale invasion in 2022. Object and methods: between January 2022 and June 2025, 205 patients with colorectal liver metastases (CLM) received either minor OLR or LLR. Primary end-points were the 30-day morbidity, surgical outcomes. Secondary outcomes were hospital costs and the oncological outcomes. Results: there was a difference in postoperative morbidity between the groups in favor of the LLR — 3.8% (n = 4) vs 11.7% (n = 12) in OLR (p = 0.04). 1.9% (n = 2) in the OLR group had major complications. No mortality was registered in either group. The final sum of costs for treatment of 103 patients in LLR vs 102 patients in OLR was 3.8M UAH vs 3.5M UAH, respectively (p = 0.82). The 2-year recurrence-free survival (RFS) was 44% vs 54% and 19.6 months vs 24.0 months respectively for OLR and LLR groups (p = 0.62). Conclusions: the laparoscopic minor liver resections in patients with colorectal cancer liver metastases in state specialized hospitals reduced the recovery period and the postoperative morbidity level with similar oncological outcomes and costs.
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